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The painting shows a panorama of an army of skeletons wreaking havoc across a blackened, desolate landscape. Fires burn in the distance, and the sea is littered with shipwrecks. A few leafless trees stud hills otherwise bare of vegetation; fish lie rotting on the shores of a corpse-choked pond. Art historian James Snyder emphasizes the "scorched, barren earth, devoid of any life as far as the eye can see."[1] In this setting, legions of skeletons advance on the living, who either flee in terror or try in vain to fight back. In the foreground, skeletons haul a wagon full of skulls; in the upper left corner, others ring the bell that signifies the death knell of the world. A fool plays the lute while a skeleton behind him plays along; a starving dog nibbles at the face of a child; a cross sits in the center of the painting. People are herded into a trap decorated with crosses, while a skeleton on horseback kills people with a scythe. The painting depicts people of different social backgrounds – from peasants and soldiers to nobles as well as a king and a cardinal – being taken by death indiscriminately.[3]

A skeleton parodies human happiness by playing a hurdy-gurdy while the wheels of his cart crush a man. A woman has fallen in the path of the death cart; she holds in her hand a spindle and distaff, classical symbols of the fragility of human life. The slender thread is about to be cut by the scissors in her other hand. Just below her a cardinal is helped towards his fate by a skeleton who mockingly wears the red hat, while a dying king's barrel of gold coins is looted by yet another skeleton. In one detail, a dinner has been broken up and the diners are putting up a futile resistance. They have drawn their swords in order to fight the skeletons dressed in winding-sheets; no less hopelessly, the jester takes refuge beneath the dinner table. The backgammon board and the playing cards have been scattered, while a skeleton thinly disguised with a mask empties away the wine flasks. Above, a woman is being embraced by a skeleton in a hideous parody of after-dinner amorousness. Of the menu of the interrupted meal, all that can be seen are a few pallid rolls of bread and an appetizer apparently consisting of a pared human skull. As the fighting breaks out, a skeleton in a hooded robe mockingly seems to bring another dish, also consisting of human bones, to the table.[4]

The painting shows aspects of everyday life in the mid-sixteenth century. Clothes are clearly depicted, as are pastimes such as playing cards and backgammon. It shows objects such as musical instruments, an early mechanical clock, scenes including a funeral service, and various methods of execution, including the breaking wheel, the gallows, and the headsman.